HOW DO WE DEVELOP EXPERTS FOR GENERAL PRACTICE/FAMILY MEDICINE EDUCATION?
In most European countries, general practice/family medicine (GP/FM) is a fundamental part of the health care system. General practitioners (GPs, family physicians) play a pivotal role in ensuring that patients acquire appropriate health care provision. A programme of specialty training and continuing education for European GPs is a crucial matter delivering high quality patient care. Such education programmes require a skilled workforce of GP teachers, who need to be trained for this purpose.
EURACT COURSES
Activities run by the European Academy of Teachers in General Practice and Family Medicine (EURACT) and the experience acquired during more than 25 years of its functioning, revealed the urgent need for a continuing framework for developing and maintaining the skills of GP teachers in GP/FM in Europe. Since practice-based training is the essential element of specialist training in GP, the shortage of teaching knowledge, skills and competences among those practising GPs who act as trainers is a crucial deficit in this activity. EURACT developed three courses helping to promote the further professional development of those practising GPs who play a key role in the vocational training of future primary care physicians.
The first Leonardo-EURACT course was developed within the Leonardo da Vinci programme run by the College of Family Physicians in Poland. This course provided the basic knowledge and skills needed for GP trainers teaching in their own practices, unified on a European level. The course was a great success: the international version has run five times and in-country courses across Europe have run many times with more than 1500 GP trainers having participated. However, the course revealed further needs in this field and EURACT received several requests to develop further courses addressing different topics of training for GP trainers. Therefore, extra courses were developed, i.e. an assessment course focusing on assessment methods, and an advanced ‘Training the trainers’ course, which looked in depth at teaching from consultation, small group leadership and facilitation, developing a curriculum and managing of underperforming trainees.
EDUCATIONAL EXPERTISE FRAMEWORK
The appreciation of the progress of the trainers through the educational modules and programmes raised the question of there being different levels of expertise of GP trainers—an issue that is not currently considered in GP training in Europe. Although GP educators in different university medical schools and postgraduate organizations in Europe may be considered experts in GP training, there is neither a definition of the levels of competence or specific skills required, nor an actual framework that would support the understanding of the need for educational experts in family medicine. Development of the ‘Educational Expertise Framework’ has been defined by EURACT as an important initiative. It has become a core of the Leonardo da Vinci Project ‘Framework for continuing educational development of trainers in general practice in Europe’ (No. 2010 - 1-PL1-LEO05 - 11460).
The objective of the project is to propose, develop and implement an educational framework for family medicine teachers working in GP education in Europe. They may be working as practice-based teachers, or in university departments or in a combination of both. Some will be teaching medical students, others specialty trainees and some may be providers of continuing professional development. The EURACT educational expertise framework (EEF) is a new conceptual document, which will define different areas of expertise of GP/FM educators, as well as different levels of educational expertise within those areas. For each level, specific educational competences will be described. It is important to mention that those competences are applied to individual (personal) expertise as opposed to organizational expertise, which is more dependent on the position within an educational institution than on the personal achievements of the educator. We expect the document to guide educators as well as the educational institutions in the journey towards becoming experts in the chosen area of GP/FM education.
The EEF implementation strategy within the Leonardo da Vinci project provides examples of the development of educational courses for GP/FM teachers at three levels:
Level 1: becoming a competent educator
Level 2: becoming a proficient educator
Level 3: becoming an educational expert
The project developed examples of each of these courses, which provide participants with a range of the educational interventions necessary for development of GP trainers towards reaching these levels.
WONCA VIENNA 2012
The document has been started by the working group of Leonardo da Vinci project experts, and developed further in the expert conference organized in March 2011 in Thessaloniki, Greece. The development of the document included a contribution by EURACT Council, specifically the Educational Expertise Taskforce, a workshop during the Wonca Europe 2011 Conference in Warsaw, as well as continuing work of Leonardo da Vinci project experts. The final document has to be approved by the EURACT Council and will be presented during the WONCA Europe conference in Vienna 2012, where the following EURACT activities will be organized:
Workshop: ‘The challenge of teaching expert teachers in family medicine’
Workshop: ‘Framework for developing teaching expertise’
Poster: ‘Continuing educational development of trainers in general practice in Europe’